Agreement of Facial Biotype According to the Ricketts Vert Index and Facial Opening Angle in Orthodontic Patients at a University Clinic in Nicaragua

Abstract

Background: Modern orthodontics emphasizes the importance of classifying facial biotypes to optimize treatment planning, using popular methods such as Ricketts' VERT index and the facial opening angle. Some studies have pointed out potential disagreements between these two methods in biotype classification. Objective: The aim of this study was to assess the agreement between the facial biotype classification according to Ricketts' VERT index and the facial opening angle in patients from the orthodontics clinic at Universidad Francisco Luis Espinoza Pineda, between January 1, 2023, and July 31, 2024. Method: In terms of methodology, an observational, cross-sectional, and correlational study was conducted with 100 patients. Facial biotypes were determined through cephalometric evaluation using the WebCeph program, calculating the VERT index, and a photographic analysis for the facial opening angle. Statistical analysis was performed in SPSS, with Chi-square tests, Pearson and Spearman correlations, linear regression, and the Kappa index. Results: The main results revealed that according to the VERT index, facial biotypes were classified as follows: 8% dolichofacial, 34% mild dolichofacial, 35% mesofacial, 7% brachyfacial, and 16% severe brachyfacial. The facial opening angle identified 34% as dolichofacial and 66% as mesofacial, with no patients classified as brachyfacial. The correlation between both methods was low and not statistically significant (p>0.05), although a significant agreement was observed in men (Kappa=0.365, p<0.05). Conclusion: The results suggest discrepancies between the VERT index and the facial opening angle in biotype classification, particularly for brachyfacial patients.